Toru Ogawa1, Maija Kiuru2, Thomas H Konia2, Maxwell A Fung3. 1. Department of Dermatology, University of California Davis, Sacramento, California. 2. Department of Dermatology, University of California Davis, Sacramento, California; Department of Pathology and Laboratory Medicine, University of California Davis, Sacramento, California. 3. Department of Dermatology, University of California Davis, Sacramento, California; Department of Pathology and Laboratory Medicine, University of California Davis, Sacramento, California. Electronic address: maxfung@ucdavis.edu.
Abstract
BACKGROUND: Acantholytic squamous cell carcinoma (aSCC) is regarded as a high-risk variant of cutaneous squamous cell carcinoma (SCC). Acantholytic actinic keratosis (aAK) has been regarded as a precursor risk factor for aSCC. However, supporting evidence is limited. OBJECTIVE: We sought to document clinical features, histologic features, management, and outcomes in a series of aSCC cases. METHODS: Definitions of aSCC, aAK, and aSCC arising in association with aAK were applied to a consecutive series of aSCC cases. Clinical characteristics and outcomes were obtained from electronic medical records. RESULTS: Of 115 aSCC cases (103 patients, mean age 71.8 years), actinic keratosis was present in 23% (27/115) but only 7.8% (9/115) exhibited associated aAK. Ten cases (10/115, 9%) fulfilled strict histologic criteria for follicular SCC as previously defined, but 50 of 115 (43%) of our aSCC cases exhibited predominant involvement of follicular epithelium rather than epidermis. Clinical outcome (median follow-up, 36 months) was available in 106 of 115 (92%). One patient experienced regional extension (parotid), and 1 patient experienced a local recurrence (nose). No disease-related metastases or deaths were documented. LIMITATIONS: This was a single-institution retrospective study from the United States. CONCLUSIONS: The presence of acantholysis in cutaneous SCC does not specifically confer aggressive behavior, a finding that may inform clinical practice guidelines.
BACKGROUND:Acantholytic squamous cell carcinoma (aSCC) is regarded as a high-risk variant of cutaneous squamous cell carcinoma (SCC). Acantholytic actinic keratosis (aAK) has been regarded as a precursor risk factor for aSCC. However, supporting evidence is limited. OBJECTIVE: We sought to document clinical features, histologic features, management, and outcomes in a series of aSCC cases. METHODS: Definitions of aSCC, aAK, and aSCC arising in association with aAK were applied to a consecutive series of aSCC cases. Clinical characteristics and outcomes were obtained from electronic medical records. RESULTS: Of 115 aSCC cases (103 patients, mean age 71.8 years), actinic keratosis was present in 23% (27/115) but only 7.8% (9/115) exhibited associated aAK. Ten cases (10/115, 9%) fulfilled strict histologic criteria for follicular SCC as previously defined, but 50 of 115 (43%) of our aSCC cases exhibited predominant involvement of follicular epithelium rather than epidermis. Clinical outcome (median follow-up, 36 months) was available in 106 of 115 (92%). One patient experienced regional extension (parotid), and 1 patient experienced a local recurrence (nose). No disease-related metastases or deaths were documented. LIMITATIONS: This was a single-institution retrospective study from the United States. CONCLUSIONS: The presence of acantholysis in cutaneous SCC does not specifically confer aggressive behavior, a finding that may inform clinical practice guidelines.
Authors: Cristel Ruini; Alexander Michael Witkowski; Annamaria Cesinaro; Nathalie Teixeira De Carvalho; Giovanni Pellacani Journal: J Am Acad Dermatol Date: 2015-01 Impact factor: 11.527
Authors: Alexander Stratigos; Claus Garbe; Celeste Lebbe; Josep Malvehy; Veronique del Marmol; Hubert Pehamberger; Ketty Peris; Jürgen C Becker; Iris Zalaudek; Philippe Saiag; Mark R Middleton; Lars Bastholt; Alessandro Testori; Jean-Jacques Grob Journal: Eur J Cancer Date: 2015-07-25 Impact factor: 9.162